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https://www.readbyqxmd.com/read/28145035/the-epidemiology-of-long-stay-patients-in-a-university-teaching-hospital
#1
Kim O'Sullivan, Johan Martensson, Raymond Robbins, K J Farley, Doug Johnson, Daryl Jones
BACKGROUND: Patients admitted to acute care hospitals may have multiple co-morbidities, and a small proportion may stay a protracted period. AIMS: To assess the proportion of hospital patients who are long stay (≥14 days), evaluate associations with baseline variables and subsequent in-patient morbidity and mortality. METHODS: Retrospective observational study of patients aged ≥ 18 years staying in hospital for at least 24 hr between 1-7-2013 and 30-6-2014...
February 1, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28133713/prescribing-error-at-hospital-discharge-a-retrospective-review-of-medication-information-in-an-irish-hospital
#2
M Michaelson, E Walsh, C P Bradley, P McCague, R Owens, L J Sahm
BACKGROUND: Prescribing error may result in adverse clinical outcomes leading to increased patient morbidity, mortality and increased economic burden. Many errors occur during transitional care as patients move between different stages and settings of care. AIM: To conduct a review of medication information and identify prescribing error among an adult population in an urban hospital. METHODS: Retrospective review of medication information was conducted...
January 30, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28119313/the-association-between-cognitive-impairment-and-functional-outcome-in-hospitalised-older-patients-a-systematic-review-and-meta-analysis
#3
Peter Hartley, Nathalie Gibbins, Amanda Saunders, Kerry Alexander, Eimear Conroy, Rebecca Dixon, Joseph Lang, Jasmine Luckett, Tim Luddington, Roman Romero-Ortuno
BACKGROUND: in hospitalised older adults, cognitive impairments are common and may be associated with functional outcomes. Our aim was to systematically review this association. METHOD: we systematically searched MEDLINE, CINAHL, AMED and PsycINFO from inception to April 2016. Non-English language studies were filtered out at search stage. All types of studies were considered for inclusion except reviews, conference abstracts, dissertations and case studies. POPULATION: community-dwelling or institutionalised older adults aged 65 years or more, who are acutely hospitalised and have information on history of dementia and/or cognitive scores on admission...
January 23, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28093812/factors-predicting-incidence-of-post-operative-delirium-in-older-people-following-hip-fracture-surgery-a-systematic-review-and-meta-analysis
#4
REVIEW
T O Smith, A Cooper, G Peryer, R Griffiths, C Fox, J Cross
OBJECTIVE: Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS: Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery...
January 17, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#5
Subeer K Wadia, Mark Belkin, Kelsey S Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
February 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28077453/state-regulatory-approaches-for-dementia-care-in-residential-care-and-assisted-living
#6
Paula C Carder
PURPOSE: This policy study analyzed states' residential care and assisted living (RC/AL) regulations for dementia care requirements. Estimates suggest that at least half of RC/AL residents have dementia, and 22% of settings provide or specialize in dementia care. Residents with dementia might benefit from regulations that account for specific behaviors and needs associated with dementia, making states' RC/AL regulations address dementia care an important policy topic. DESIGN AND METHODS: This study examined RC/AL regulations in all 50 states and the District of Columbia for regulatory requirements on five topics important to the quality of life of RC/AL residents with dementia: pre-admission assessment, consumer disclosure, staffing types and levels, administrator training, and physical environment...
January 10, 2017: Gerontologist
https://www.readbyqxmd.com/read/27965823/feasibility-of-a-stepped-wedge-cluster-rct-and-concurrent-observational-sub-study-to-evaluate-the-effects-of-modified-ward-night-lighting-on-inpatient-fall-rates-and-sleep-quality-a-protocol-for-a-pilot-trial
#7
Satyan R Chari, Simon Smith, Alison Mudge, Alex A Black, Mariana Figueiro, Muhtashimuddin Ahmed, Mark Devitt, Terry P Haines
BACKGROUND: Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27943349/problems-with-continuity-of-care-identified-by-community-pharmacists-post-discharge
#8
H T Ensing, E S Koster, P I van Berkel, A A van Dooren, M L Bouvy
WHAT IS KNOWN AND OBJECTIVE: Medication discrepancies are common at hospital discharge, and medication reconciliation is widely endorsed as a preventive strategy. However, implementation is difficult for instance due to the unreliability of patients medication histories. In the Netherlands, community pharmacies are well-informed about their patients' pre-admission medication status which enables thorough post-discharge reconciliation. Our aim was to study the frequency and nature of medication discrepancies, missing patient's knowledge and administrative problems at admission to primary care...
December 10, 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27935649/intense-pre-admission-carriage-and-further-acquisition-of-esbl-producing-enterobacteriaceae-among-patients-and-their-caregivers-in-a-tertiary-hospital-in-rwanda
#9
Mathis S E Kurz, Claude Bayingana, Jules M Ndoli, Augustin Sendegeya, Anita Durst, Roland Pfüller, Jean Bosco Gahutu, Frank P Mockenhaupt
OBJECTIVES: To assess the presence and risk factors of intestinal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) among patients admitted to the University Teaching Hospital of Butare and among their attending caregivers, and to analyse the acquisition of ESBL-PE carriage during hospital stay and associated factors. METHODS: We screened 392 patients and their attending caregivers at admission and discharge for ESBL-PE carriage...
February 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27900737/three-year-mortality-in-30-day-survivors-of-critical-care-with-acute-kidney-injury-data-from-the-prospective-observational-finnaki-study
#10
Henriikka Mildh, Ville Pettilä, Anna-Maija Korhonen, Sari Karlsson, Tero Ala-Kokko, Matti Reinikainen, Suvi T Vaara
BACKGROUND: The role of an episode of acute kidney injury (AKI) in long-term mortality among initial survivors of critical illness is controversial. We aimed to determine whether AKI is independently associated with decreased survival at 3 years among 30-day survivors of intensive care. RESULTS: We included 2336 30-day survivors of intensive care enrolled in the FINNAKI study conducted in seventeen medical-surgical ICUs in Finland during a 5-month period in 2011-2012...
December 2016: Annals of Intensive Care
https://www.readbyqxmd.com/read/27863876/scoping-review-the-use-of-early-warning-systems-for-the-identification-of-in-hospital-patients-at-risk-of-deterioration
#11
REVIEW
Marie Danielle Le Lagadec, Trudy Dwyer
INTRODUCTION: Early warning systems (EWS) were developed as a means of alerting medical staff to patient clinical decline. Since 85% of severe adverse events are preceded by abnormal physiological signs, the patient bed-side vital signs observation chart has emerged as an EWS tool to help staff identify and quantify deteriorating patients. There are three broad categories of patient observation chart EWS: single or multiple parameter systems; aggregated weighted scoring systems; or combinations of single or multiple parameter and aggregated weighted scoring systems...
November 15, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/27817882/does-early-beta-blockade-in-isolated-severe-traumatic-brain-injury-reduce-the-risk-of-post-traumatic-depression
#12
Rebecka Ahl, Gabriel Sjolin, Shahin Mohseni
INTRODUCTION: Depressive symptoms occur in approximately half of trauma patients, negatively impacting on functional outcome and quality of life following severe head injury. Pontine noradrenaline has been shown to increase upon trauma and associated β-adrenergic receptor activation appears to consolidate memory formation of traumatic events. Blocking adrenergic activity reduces physiological stress responses during recall of traumatic memories and impairs memory, implying a potential therapeutic role of β-blockers...
January 2017: Injury
https://www.readbyqxmd.com/read/27787771/patterns-of-drug-use-and-serum-sodium-concentrations-in-older-hospitalized-patients-a-latent-class-analysis-approach
#13
Richard J Woodman, Karen M Wood, Aline Kunnel, Maneesha Dedigama, Matthew A Pegoli, Roy L Soiza, Arduino A Mangoni
BACKGROUND: Several drugs may lower serum sodium concentrations (NaC) in older patients. However, distinguishing their individual effects is particularly difficult in this population because of the high prevalence of polypharmacy and disease states that are per se associated with hyponatremia. OBJECTIVES: Our objective was to identify specific patterns of medication use in older hospitalized patients and determine whether these patterns were associated with serum NaC...
December 2016: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/27748206/prognostic-effect-of-pre-and-post-admission-antibiotic-treatment-in-paediatric-acute-mastoiditis
#14
E Carmel, J H Curotta, A T Cheng
OBJECTIVE: To evaluate the effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis. DESIGN: Retrospective study. METHOD: Eighty-eight children with acute mastoiditis, from 2003 to 2012, were studied to investigate the effect of antibiotic therapy on short and long-term sequelae. RESULTS: The median period of antibiotic therapy immediately following hospital discharge was 10 days (range, 5-49 days; standard deviation = 7...
January 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/27744415/examining-the-importance-of-admissions-criteria-in-predicting-nursing-program-success
#15
Oscar Wambuguh, Monika Eckfield, Lynn Van Hofwegen
Baccalaureate nursing programs select students likely to graduate, become licensed, and contribute to a diverse workforce, and admissions criteria need to support those goals. This study assessed five criteria: pre-admit science GPA; TEAS score; healthcare experience; previous baccalaureate degree; and pre-admission university enrollment vs. college transfer as predictors of three desired outcomes: graduation; nursing program GPA; and passing NCLEX-RN. Results found TEAS and pre-admit science GPA predicted nursing program outcomes...
September 20, 2016: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/27622778/retrospectively-patient-reported-pre-event-health-status-showed-strong-association-and-agreement-with-contemporaneous-reports
#16
REVIEW
Esther Kwong, Nick Black
OBJECTIVE: The unpredictability of the occurrence of illnesses and injuries leading to most emergency admissions to hospital makes it impossible prospectively to collect pre-admission patient reported outcome measures (PROMs). Our aims were to review the evidence for using retrospective PROMs to determine pre-event health status and the validity of using general population norms instead of retrospective PROMs. STUDY DESIGN AND SETTING: Searches of Medline, PsycINFO, Embase, Global Health, and Health Management information...
September 10, 2016: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/27616965/early-discharge-planning-and-improved-care-transitions-pre-admission-assessment-for-readmission-risk-in-an-elective-orthopedic-and-cardiovascular-surgical-population
#17
Brenda Ohta, Ana Mola, Peri Rosenfeld, Shauna Ford
BACKGROUND/METHODS: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan...
2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/27608340/use-of-the-montreal-cognitive-assessment-test-to-investigate-the-prevalence-of-mild-cognitive-impairment-in-the-elderly-elective-surgical-population
#18
N A Smith, Y Y Yeow
Postoperative cognitive disorders are common in elderly patients. Pre-existing cognitive impairment including mild cognitive impairment may be an important risk factor for developing postoperative cognitive dysfunction and may not be detected in a standard preoperative interview, yet is not routinely sought. Our primary aim was to estimate the prevalence of mild cognitive impairment among elderly patients presenting to our hospital for elective surgery using a simple established screening tool: the Montreal Cognitive Assessment test...
September 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27596721/clinical-frailty-adds-to-acute-illness-severity-in-predicting-mortality-in-hospitalized-older-adults-an-observational-study
#19
Roman Romero-Ortuno, Stephen Wallis, Richard Biram, Victoria Keevil
AIM: Frail individuals may be at higher risk of death from a given acute illness severity (AIS), but this relationship has not been studied in an English National Health Service (NHS) acute hospital setting. METHODS: This was a retrospective observational study in a large university NHS hospital in England. We analyzed all first non-elective inpatient episodes of people aged ≥75years (all specialties) between October 2014 and October 2015. Pre-admission frailty was assessed with the Clinical Frailty Scale (CFS) of the Canadian Study on Health & Aging, and AIS in the Emergency Department was measured with a Modified Early Warning Score (ED-MEWS<4 was considered as low acuity, and ED-MEWS≥4 as high acuity)...
November 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27595266/the-effect-of-age-on-characteristics-and-mortality-of-intracerebral-hemorrhage-in-the-oldest-old
#20
Paola Forti, Fabiola Maioli, Michele Domenico Spampinato, Carlotta Barbara, Valeria Nativio, Maura Coveri, Marco Zoli, Luigi Simonetti, Giuseppe Di Pasquale, Gaetano Procaccianti
BACKGROUND: Incidence of acute intracerebral hemorrhage (ICH) increases with age, but there is a lack of information about ICH characteristics in the oldest-old (age ≥85 years). In particular, there is a need for information about hematoma volume, which is included in most clinical scales for prediction of mortality in ICH patients. Many of these scales also assume that, independent of ICH characteristics, the oldest-old have a higher mortality than younger elderly patients (age 65-74 years)...
2016: Cerebrovascular Diseases
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